Role of MRI in the evaluation of painfull knee joint in a tertiary health care

Abstract

Introduction: Knee joint injuries and disease conditions that cause disruption of ligament, menisci, articular cartilage and other structures causing painful knee result in significant morbidity and disability. Aim: To describe the MRI features of various types of traumatic and non-traumatic lesions associated with painful knee. Materials and Methods: This hospital based descriptive study was conducted in a tertiary care institute (n=50) using 1.5T MRI for patients being referred to Department of Radiodiagnosis for the evaluation of painful knee were included in the study and results analysed by a descriptive analysis. Results: Meniscal tears were the commonest soft tissue abnormality in our study. Posterior horn of the medial meniscus were commonly involved and mostly of Grade 3. Commonest type of meniscal tear was vertical tear and usually associated with history of trauma. The commonest manifestation affecting the ACL was tear, predominantly acute in nature. Complete PCL tear was the commonest manifestation among PCL abnormalities. One quarter of the patients had associated bone contusion, femur was predominantly involved followed by lateral tibial condyle. Acute ACL tears were particularly associated with bone contusions. Popliteal cyst was the commonest cystic lesion and usually associated with coexisting effusions and meniscal tears. Osteoarthritic process was most commonly involved in the Patello-femoral compartment. Conclusion: For evaluation of painful knee, MRI is an accurate, cost-effective and a non-invasive choice of investigation. MRI can demonstrate the exact nature and extent of bony as well as soft tissue abnormality and is helpful in clinical decision making. Multiplanar imaging capacity of MRI enables a satisfactory diagnosis in such patients in whom a complete clinical examination is almost impossible due to pain.